To the Editor: In their meta-analysis, Dr de Boer and colleagues1 found that cancer survivorship was associated with unemployment. The purpose of this study was to examine the association of prognostic factors with unemployment and to identify groups of cancer survivors at highest risk for unemployment. However, the authors did not include cancer treatment as a possible prognostic factor.
Being treated with chemotherapy was a significant predictor of work changes after cancer diagnosis in our study of 403 Dutch long-term cancer survivors with a job before diagnosis.2 A Finnish study of 591 employed patients with cancer also concluded that both men and women who were treated with chemotherapy had more than twice the risk of impaired physical work ability than those who had received other treatments.3 A prospective Dutch study by de Boer et al4 of return to work in cancer patients reported that patients who received chemotherapy showed low work ability scores. Moreover, our study2 showed that patients treated with chemotherapy reported lower vitality scores as measured by the 36-Item Short Form Health Survey compared with patients treated otherwise, which can at least in part explain why chemotherapy was a significant predictor of work change.
Because the indication for chemotherapy has broadened in the past years,5 we expect more problems related to employment among cancer survivors in the near future. Rehabilitation programs that improve vitality among cancer patients after treatment may help positively influence workforce participation and thus have a large social effect, since half of cancer survivors experience work changes after cancer.2
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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